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Social Security Number

Revised Date:

June 4, 2018

Purpose: To explain the social security number (SSN) requirements and instructions for obtaining SSNs for applicants and recipients for Apple Health.

WAC 182-503-0515 Washington apple health -- Social Security number requirements.

Effective May 24, 2018

To be eligible for Washington apple health (medicaid), or tailored supports for older adults (TSOA) described in WAC 182-513-1610, you (the applicant or recipient) must provide your valid Social Security number (SSN) or proof of application for an SSN to the medicaid agency or the agency's designee, except as provided in subsections (2) and (6) of this section.
An SSN is not required if you are:
1. Not eligible to receive an SSN or may only be issued or may only be issued an SSN for a valid nonwork reason described in 20 C.F.R. 422.104;
2. A household member who is not applying for apple health coverage, unless verification of that household member's resources is required to determine the eligibility of the client;
3. Refusing to obtain an SSN for well-established religious objections as defined in 42 C.F.R. 435.910 (h) (3); or
4. Not able to obtain or provide an SSN because you are a victim of domestic violence.
If you are receiving coverage because you meet an exception under either subsection (2) (c) or (d) of this section, we (the agency) will confirm with you at your apple health renewal, consistent with WAC 182-503-0050, that you still meet the exception.
If we ask for confirmation that you continue to meet an exception in subsection (2) of this section and you do not respond in accordance with subsection (3) of this section, or if you no longer meet an exception and do not provide your SSN, we will terminate your apple health coverage according to WAC 182-518-0025.
If you are not able to provide your SSN, either because you do not know it or it has not been issued, you must provide:
1. Proof from the Social Security Administration (SSA) that you turned in an application for an SSN; and
2. The SSN when you receive it.
  1. Your apple health coverage will not be delayed, denied, or terminated while waiting for SSA to send you your SSN. If you need help applying for an SSN, assistance will be provided to you.
  2. We will ask you every ninety days if your SSN has been issued.
An SSN is not required for the following apple health programs:
1. Refugee medical assistance program described in WAC 182-507-0120, and 182-507-0125;
2. Alien medical programs described in WAC 182-507-0115, 182-507-0120, and 182-507-0125;
3. Newborn medical program described in WAC 182-505-0210 (2)(a);
4. Foster care program for a child age eighteen and younger as described in WAC 182-505-0211(1); or
5. Medical programs for children and pregnant women who do not meet citizenship or immigration status described in WAC 182-503-0535 (2)(e)(ii) and (iii).
If you are required to provide an SSN under this section, and you do not meet an exception under subsection (2) of this section, failure to provide an SSN may result in:
1. Denial of your application or termination of your coverage because we cannot determine your household's eligibility; or
2. Inability to apply the community spouse resource allocation (CSRA) or monthly maintenance needs allowance (MMNA) for a client of long-term services and supports (LTSS).

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

Clarifying Information

A valid Social Security Number (SSN) or proof that an individual has submitted an application for a SSN is required for all Apple Health programs except for the programs listed in subsection 6 of WAC 182-503-0515.
If an individual is otherwise eligible for Apple Health, coverage is approved and time allowed to provide their SSN, proof an SSN was applied for, or proof they meet a good cause exception.
Household members who are not applying for coverage are not required to provide their SSN. However, for long-term services and supports, a community spouse needs to provide an SSN for DSHS to use the community spouse resource allocation (CSRA) or monthly maintenance needs allowance (MMNA).
An individual who refuses to apply for or provide an SSN due to religious beliefs must provide verification from a church elder or other officiant showing the individual is a member and that providing or applying for an SSN is against the church doctrine. Personal, cultural, or political beliefs do not qualify as a religious objection to providing or applying for an SSN.
If a current and valid SSN is not available and the individual needs to pay an agency for a copy of his or her birth certificate, the agency must help the individual obtain the birth certificate and pay for any applicable fees. The individual receives Apple Health during this time if otherwise eligible.
ACES and Healthplanfinder automatically submit every SSN to the SSA for validation.
Individuals who are required to provide an SSN, but refuse to do so without good cause are not eligible for Apple Health.

Worker Responsibilities

Document all actions taken to comply with SSN requirements for Apple Health programs.
For applications in ACES, see the SSN chapter in the ACES manual.
1. Verification
  1. If SOLQ shows that the SSN does not belong to the individual or otherwise does not validate, send a request for verification of the SSN.
  2. If the individual sends verification, update the SSN and try to revalidate through SOLQ. If SOLQ does not validate the SSN, deny or close coverage.
  3. If the individual does not send verification or otherwise refuses to cooperate, close coverage.
2. If the applicant does not provide an SSN that is required:
  1. Pend the application and send ACES Letter 023-08 (SSN Referral) to refer the applicant to Social Security Administration District Office (SSADO) for:
    1. Application for a SSN;
    2. Application for a replacement card; or
    3. Determination of a previously issued number.
For applications in Healthplanfinder (note Healthplanfinder automatically tries to validate every SSN):
1. Verification
  1. If Healthplanfinder has not validated the SSN:
    1. Manually access SOLQ;
    2. Recheck and reverify the SSN; and
    3. Do a name/DOB search to see if the client already exists in ACES.
  2. If SOLQ shows that the SSN does not belong to the individual or otherwise does not validate:
    1. Update the application with "SSN good cause" and approve coverage.
    2. If an Additional Verification letter did not already go out for verification of SSN from Healthplanfinder, send one.
    3. Set a follow-up tickle.
  3. If the individual sends verification, revalidate the SSN through SOLQ.
    1. If SOLQ does not validate the SSN, close coverage.
    2. If the individual does not send verification or otherwise refuses to cooperate, close coverage.
If an individual requests assistance in obtaining an SSN:
1. Confirm they are required to provide an SSN based on WAC 182-503-0515(2)
2. Provide resources to individuals required to provide an SSN:
  1. SSA website
  2. SSA office locator
  3. Individuals in urgent situations can receive assistance from Regional Public Affairs Office:
    1. Phone: 303-884-1888
    2. Email: den.sea.public@affairs.ssa.gov
Good cause.
1. An individual can be granted good cause for not providing or applying for an SSN for certain reasons and periods of time. These are the reasons for good cause:
  1. Survivors of domestic violence who fear providing SSNs for themselves and/or their children will put them in danger. Good cause is granted for the certification period and rechecked yearly to see if the survivors feel safe enough to provide an SSN.
  2. Individuals claiming well-established religious objections. The individual must verify they are a member of a recognized religious sect or division of the sect and adheres to the tenets or teachings of the sect or division of the sect and for that reason is conscientiously opposed to applying for or using a national identification number. Good cause is granted for the certification period and rechecked yearly to see if the individual still claims the religious objection.
  3. Exception to rule on a case by case basis.
  4. SSN application pending with SSA. The individual receives coverage when the SSN app is pending with SSA. The agency checks with the individual every 90 days to obtain the issued SSN or check the status of the application. The individual must make substantial and reasonable efforts to supply SSA with the necessary information. The agency will assist the individual with applying for the SSN if the individual requests assistance.
  5. Good cause doesn't include delays due to illness, lack of transportation, temporary absence, or failure to respond to the SSN request.
  6. Every action of the good cause process must be documented in the ACES narrative.
Adoption Cases:
1. Domestic adoption
  1. When a child is being adopted or given adoption support through Children’s Administration, the child’s SSN is not always entered into ACES for confidentiality reasons. It is verified as valid by the Foster Care unit through FamLink and SOLQ. Actions are documented in the case narrative and in Remarks behind DEM1 screen and the child’s SSA/SSN Referral field is coded with “E” (Exception to Policy).
  2. Do not request an SSN until adoption is finalized.
2. International adoption
  1. Effective February 27, 2001 adopted children born outside of the U.S. are granted automatic citizenship upon their arrival. Refer to the above procedures to obtain and verify SSN.